ABSTRACT

Long-term sequelae of cancer and its treatment render childhood cancer (CC) survivors vulnerable to cognitive and behavioural difficulties and likely affect their quality of life (QoL). Our aim was to compare levels of cognition, psychosocial functioning, and health-related QoL of CC survivors to healthy controls and examine the associations between these three domains. Seventy-eight CC survivors (age range = 7–16 years, ≥ one year since cancer treatment) and 56 healthy controls were included. Cognition (i.e., fluid intelligence, executive functions, memory, processing speed, and selective attention), psychosocial functioning, and health-related QoL were assessed using standardized tests and questionnaires. The cognitive performance, parent-reported psychosocial behaviour, and health-related QoL of the CC survivors were within the normative range. However, working memory was significantly poorer in survivors than controls, and visuospatial working memory below the normative range was more commonly observed among survivors than among controls. Processing speed significantly predicted survivors’ performance in executive functions. Among survivors, greater peer problems were significantly associated with poorer cognitive functions and health-related QoL. Despite the evidence for good intellectual functioning, which might point towards adequate reserves, in some survivors, domain-specific difficulties may emerge years after cancer relating to psychosocial development and QoL.

摘要

癌症的长期后遗症及其治疗使儿童癌症 (CC) 幸存者容易出现认知和行为困难，并可能影响他们的生活质量 (QoL)。我们的目的是比较 CC 幸存者与健康对照组的认知、心理社会功能和健康相关的生活质量水平，并检查这三个领域之间的关联。包括 78 名 CC 幸存者（年龄范围 = 7-16 岁，癌症治疗后 ≥ 1 年）和 56 名健康对照。认知（即流体智力、执行功能、记忆、处理速度和选择性注意）、心理社会功能和与健康相关的生活质量使用标准化测试和问卷进行评估。CC 幸存者的认知表现、父母报告的心理社会行为和与健康相关的生活质量均在规范范围内。然而，幸存者的工作记忆明显比对照组差，并且在幸存者中观察到低于正常范围的视觉空间工作记忆比在对照组中更常见。处理速度显着预测了幸存者在执行功能方面的表现。在幸存者中，更大的同伴问题与较差的认知功能和健康相关的生活质量显着相关。尽管有证据表明智力功能良好，这可能表明有足够的储备，但在一些幸存者中，特定领域的困难可能会在与心理社会发展和生活质量相关的癌症发生数年后出现。处理速度显着预测了幸存者在执行功能方面的表现。在幸存者中，更大的同伴问题与较差的认知功能和健康相关的生活质量显着相关。尽管有证据表明智力功能良好，这可能表明有足够的储备，但在一些幸存者中，特定领域的困难可能会在与心理社会发展和生活质量相关的癌症发生数年后出现。处理速度显着预测了幸存者在执行功能方面的表现。在幸存者中，更大的同伴问题与较差的认知功能和健康相关的生活质量显着相关。尽管有证据表明智力功能良好，这可能表明有足够的储备，但在一些幸存者中，特定领域的困难可能会在与心理社会发展和生活质量相关的癌症发生数年后出现。